Internet-delivered cognitive behaviour therapy for chronic health conditions with and without guidance: exploring changes in benefit finding
La Posta, Giuliano
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Chronic health conditions can have a disabling effect on an individual’s mental health. Most interventions for individuals with chronic health conditions target negative consequences of chronic health conditions such as anxiety and depression. Individuals, however, may benefit from developing positive insights from the life changes that can occur when facing adverse life situations, a process known as benefit finding. The primary objective of the current study was to evaluate the effectiveness of an 8 week internet-delivered cognitive behavioral therapy (ICBT) program on reducing anxiety and depression but also improving benefit finding among those with chronic health conditions. The study also compared outcomes when the program was selfdirected versus when participants were guided through the course by a team of providers (teamdirected). Participants (n = 60) residing in Canada suffering from a chronic health condition and experiencing symptoms of anxiety and/or depression were randomized into a team-directed or self-directed ICBT. Participants completed outcomes at pre-treatment and then again at posttreatment. Self-directed ICBT was associated with slightly lower course completion compared to team-directed ICBT (65.6% vs. 71.4%). Of note post-treatment completion rates were 47% in self-directed and 57% in team-directed ICBT. In both conditions, small improvements in benefit finding were seen over treatment (within Cohen’s d = 0.34). Large effects were observed on anxiety and depression as well as distress and quality of life (within Cohen’s d range 0.11 to 1.02). Both team-directed and self-directed ICBT have significant potential to improve access to mental health care among those with chronic health conditions.